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【Scientific Research Report】Titin N-terminal fragment: a useful biomarker for various muscle-disrupting diseases

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Product News2024/09/12: 【Scientific Research Report】Titin N-terminal fragment: a useful biomarker for various muscle-disrupting diseases

IBL products introduced in this IBL news are applicable for research use only and cannot be used for diagnostic or medical purposes.

Various research papers have been published on the Titin N-terminal fragment.

Titin N-terminal fragment (N-Titin) has been identified as a biomarker specifically detected in the urine of Duchenne muscular dystrophy (DMD) patients, based on proteome analysis of urine samples from DMD patients and healthy controls (PMID: 24813925).

Subsequently, an ELISA kit to detect N-Titin in urine samples was developed by a research group including our company (PMID: 27991570).

As shown in the table below, the possible association of urinary N-Titin with various diseases or physiological conditions that exhibit muscle damage or atrophy has been investigated by the ELISA method, and urinary N-Titin has been reported as a useful biomarker in research for these diseases and physiological conditions.

Diseases/Physiological conditions		Publication PMID
Muscular dystrophies	Duchenne muscular dystrophy	38229112, 36871413, 33046751, 30053403, 29870683, 29175173, 27991570
	Becker muscular dystrophy	32859695
	Myotonic dystrophy	37291994, 29870683
	Limb-girdle muscular dystrophy	29870683
	Fukuyama congenital muscular dystrophy	33563515
Cardiac diseases	Acute myocardial infarction	38203744
	Dilated cardiomyopathy(prognostic prediction)	29523227
	Muscle injuries during the perioperative period	30800662
Cranial nerve disease	Amyotrophic lateral sclerosis (ALS)	33737450
Cranial nerve disease	Muscle atrophy after acute stroke	33360523
Other diseases	Disseminated intravascular coagulopathy	36565648
Other diseases	Catabolic state of infants	34274960
ICU-AW		34863251, 32706557, 32968587, 32345334
Sarcopenia		37322176, 33802012, 32866763, 31862937
Exercise-induced muscle damage		36523897, 33722155, 33337691, 32132835, 31928880, 38045754

One of the advantages of urinary N-Titin is the non-invasive nature of the sampling. Invasive muscle biopsies and blood tests are performed to diagnose muscular dystrophies, but in children, for example, even blood sampling may be difficult.

In the literature (PMID: 30053403), urine samples from 3-year-old children were used to evaluate whether N-Titin could serve as a biomarker for identifying DMD patients. The research results indicates that urinary N-Titin may be a non-invasive biomarker that can be easily applied even for children.

Urinary N-Titin also offers an advantage in terms of accuracy as a biomarker used in research.
For example, the literature (PMID: 29870683) explores the potential of urinary N-Titin as a biomarker in research to distinguish between muscular dystrophy and cardiomyopathy.
In some cardiomyopathy patients with underlying muscular dystrophy, the complications of muscular dystrophy may be overlooked when systemic symptoms such as muscle weakness are not prominent.
In this paper, the accuracy for distinguishing between muscular dystrophy and cardiomyopathy is examined by ROC analysis. The AUC value (a value indicating the accuracy of distinguishing between them) using creatinine-corrected N-Titin concentration was 0.92, whereas the AUC value using serum creatinine kinase concentration (CK), which is conventionally used for the diagnosis of muscular dystrophy, was 0.75. Thus, it has been suggested that urinary N-Titin can distinguish muscular dystrophy with higher accuracy than CK.

ICU-AW is a neuromuscular disorder with muscle weakness that arises during the treatment of critically ill patients in the intensive care unit. Despite its high incidence, early detection of ICU-AW is not easy. Several papers listed in the above table have reported that urinary N-Titin is a useful biomarker in research for ICU-AW.

One article (PMID: 33030965) compares the AUC values (accuracy in finding patients with ICU-AW) for N-Titin and CK. The AUC for creatinine-corrected urinary N-Titin was 0.81, while the AUC for serum CK was 0.65. It has been suggested that urinary N-Titin is more accurate than CK in identifying patients with ICU-AW in this research report.

In summary, urinary N-Titin is a non-invasive and highly accurate biomarker that can be used to study various diseases or physiological conditions that exhibit muscle damage or atrophy.

Note that further research is needed on this biomarker to establish its clinical significance.

We offer a wide variety of kits for the determination of N-Titin. Click here for more details.
We hope this information will be useful for your research.

Click here for publications information.

Keyword: Titin, Ntitin, Connectin, sports medicine, cardiac disease, NAFLD, sarcopenia and frailty

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